Invasive fungal infection in allogeneic hematopoietic stem cell transplant recipients: single center experiences of 12 years
Invasive fungal infection in allogeneic hematopoietic stem cell transplant recipients: single center experiences of 12 years
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DOI：
10.1631/jzus.b1500005
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发表时间：
2015-09-01
影响因子：
5.1
通讯作者：
Huang, He
中科院分区：
文献类型：
--
作者：
Shi, Ji-min;Pei, Xu-ying;Huang, He
侵袭性真菌感染（IFI）是异基因造血干细胞移植（allo-HSCT）后患者发病率和死亡率不断上升的原因。我们回顾性分析了1998年11月至2009年12月期间接受allo-HSCT的408例患者的记录，分析了IFI的发生率和危险因素，并检查了IFI对总生存率的影响。共有92例（22.5%）发作证实或可能发生IFI（4例患者证实，88例患者可能）。念珠菌是早期IFI最常见的病原体，霉菌是晚期IFI最常见的病原体。IFI的既往病史、人类白细胞抗原（HLA）不匹配、长期中性粒细胞减少和急性移植物抗宿主病（GVHD）是早期IFI的危险因素。IFI既往史、皮质类固醇治疗、巨细胞病毒（CMV）疾病和慢性GVHD是晚期IFI的危险因素。IFI相关死亡率为53.26%。IFI组的12年总生存率（OS）为41.9%，明显低于非IFI组的63.6%（P < 0.01）。
Invasive fungal infection (IFI) is a growing cause of morbidity and mortality among patients after allogeneic hematopoietic stem cell transplantation (allo-HSCT). We retrospectively reviewed the records of 408 patients undergoing allo-HSCTs during the period November 1998 to December 2009, analyzed the incidence and risk factors of IFI, and examined the impact of IFI on overall survival. A total of 92 (22.5%) episodes suffered proven or probable IFI (4 patients were proven, 88 patients were probable). Candida was the most common pathogen for early IFI, and mold was the most frequent causative organism for late IFI. A prior history of IFI, human leukocyte antigen (HLA) mismatch, long-time neutropenia, and acute graft-versus-host-disease (GVHD) were risk factors for early IFI. A prior history of IFI, corticosteroid therapy, cytomegalovirus (CMV) disease, and chronic GVHD were risk factors for late IFI. IFI-related mortality was 53.26%. The 12-year overall survival (OS) rate for IFI was significantly lower than that of patients without IFI (41.9% vs. 63.6%, P < 0.01).